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    Medicare Advantage · South Dakota · enrollment Oct 2026

    Medicare Advantage in South Dakota: 44,159 members, 5 carriers, Medica Holding Company in front.

    Medica Holding Company holds 40.3% of South Dakota’s visible Medicare Advantage members, ahead of Blue Cross Blue Shield of Michigan Mutual Ins. Co. at 23.6% and UnitedHealth at 14.1%. The market shrank −1.3% (−568 members) from Nov 2025 to Oct 2026 and stepped −9.2% at the 2026 election period. 35.1% of the state's Medicare beneficiaries are in a Medicare Advantage plan.

    Visible members
    44,159
    Oct 2026
    Carriers
    5
    19 plans with members
    MA penetration
    35.1%
    of 208,654 eligible
    Twelve months
    −1.3%
    −568 members
    Election step
    −9.2%
    December to January 2026
    Top three
    78.0%
    HHI 2,621, highly concentrated

    Every carrier with members in South Dakota

    Ranked by visible members in Oct 2026. The twelve-month change runs Nov 2025 to Oct 2026; the election step is the carrier’s own December-to-January change. Counties led counts counties where the carrier has the most visible members and at least one other carrier is visible. Medica Holding Company leads 15 of the 37 counties with a lead. At the election period Medica Holding Company stepped up most (+145.7%) and UnitedHealth stepped down most (−44.5%).

    #CarrierMembersShareTwelve monthsElection stepCounties ledRating$0 premiumPlans
    1Medica Holding Company17,789
    40.3%
    		+172.5%+145.7%15 of 184.0038%4
    2Blue Cross Blue Shield of Michigan Mutual Ins. Co.10,431
    23.6%
    		−26.3%−29.9%14 of 39––3
    3UnitedHealth6,227
    14.1%
    		−40.9%−44.5%4 of 384.50100%3
    4Aetna (CVS)4,923
    11.2%
    		−30.0%−38.2%2 of 274.0076%5
    5Sanford Health4,789
    10.8%
    		+28.8%+18.5%2 of 204.0091%4

    South Dakota county by county

    51 counties with visible members, largest first. A county’s leader is the carrier with the most visible members there; a county with one visible carrier shows no leader, because the others are suppressed, not absent. Penetration is Medicare Advantage members as a share of the county’s Medicare beneficiaries.

    CountyVisible membersCarriersLeaderLeader shareMA penetrationDual eligibles
    Minnehaha9,0574Sanford Health34.0%41.9%4,308
    Pennington8,4274Medica Holding Company65.5%30.2%2,643
    Codington3,1473Medica Holding Company92.1%47.5%704
    Lawrence2,7813Medica Holding Company61.6%35.1%679
    Brookings2,6295Blue Cross Blue Shield of Michigan Mutual Ins. Co.43.4%44.9%558
    Lincoln2,5074Sanford Health34.5%46.1%611
    Meade2,0083Medica Holding Company67.2%28.9%519
    Davison1,7884Blue Cross Blue Shield of Michigan Mutual Ins. Co.43.3%38.3%646
    Butte1,1023Medica Holding Company56.9%42.9%311
    Custer9533Medica Holding Company66.6%32.2%168
    Union8023Aetna (CVS)84.0%32.7%230
    Roberts7434Medica Holding Company56.9%32.6%270
    Fall River6863Medica Holding Company62.8%26.3%267
    Yankton5993Blue Cross Blue Shield of Michigan Mutual Ins. Co.41.6%35.4%719
    Hamlin5613Medica Holding Company91.4%45.8%102
    Day5234Medica Holding Company82.6%34.5%149
    Kingsbury4475Medica Holding Company49.0%32.0%128
    Deuel4344Medica Holding Company65.4%40.7%81
    Clark4254Medica Holding Company72.7%49.7%115
    Spink4143Medica Holding Company76.3%25.9%229
    Clay4004Aetna (CVS)33.8%33.4%267
    Turner3674Blue Cross Blue Shield of Michigan Mutual Ins. Co.43.9%51.2%164
    Marshall3465Medica Holding Company79.2%33.3%90
    Lake3314Blue Cross Blue Shield of Michigan Mutual Ins. Co.45.6%34.6%216
    Beadle3202UnitedHealth53.4%41.9%639
    McCook2734Blue Cross Blue Shield of Michigan Mutual Ins. Co.31.1%46.0%126
    Charles Mix2503UnitedHealth46.4%24.5%281
    Bon Homme2034Blue Cross Blue Shield of Michigan Mutual Ins. Co.37.4%36.2%172
    Brown1941one visible carrier–29.1%916
    Hutchinson1944Blue Cross Blue Shield of Michigan Mutual Ins. Co.43.3%37.3%153
    Sanborn1763Blue Cross Blue Shield of Michigan Mutual Ins. Co.50.0%33.5%64
    Moody1704Blue Cross Blue Shield of Michigan Mutual Ins. Co.56.5%30.6%140
    Hanson1443Blue Cross Blue Shield of Michigan Mutual Ins. Co.59.0%31.9%67
    Walworth1433Blue Cross Blue Shield of Michigan Mutual Ins. Co.48.9%21.9%160
    Douglas912Blue Cross Blue Shield of Michigan Mutual Ins. Co.68.1%28.1%73
    Miner873Blue Cross Blue Shield of Michigan Mutual Ins. Co.60.9%33.9%59
    Aurora551one visible carrier–32.0%30
    Dewey471one visible carrier–10.5%182
    Jackson472UnitedHealth70.2%22.5%70
    Edmunds451one visible carrier–26.1%74
    Corson432UnitedHealth65.1%21.3%155
    Hughes411one visible carrier–21.5%313
    Haakon311one visible carrier–16.6%39
    Brule281one visible carrier–33.3%145
    Harding181one visible carrier–16.6%–
    Perkins161one visible carrier–23.6%72
    McPherson141one visible carrier–24.8%81
    Gregory131one visible carrier–20.5%125
    Hand131one visible carrier–15.4%79
    Jerauld131one visible carrier–24.3%45
    Ziebach131one visible carrier–17.3%48

    South Dakota's twelve months

    Visible Medicare Advantage members in South Dakota each month, Nov 2025 to Oct 2026. The December-to-January step is the election period; the rest of the year moves on new eligibles, special enrollment and deaths.

    Nov 2025 · 44,727Oct 2026 · 44,159

    What 2027 does to South Dakota

    The fate assigned to every plan for 2027, joined to the members in it today. A plan that ends sends its members to choose again; a plan dropping counties keeps the plan but not every county, and which counties is not stated.

    Plans that end
    14,917

    members in South Dakota are in plans that end for 2027.

    • Blue Cross Blue Shield of Michigan Mutual Ins. Co.10,431
    • Sanford Health4,486
    Plans dropping counties
    8,943

    members are in plans that keep selling in South Dakota but drop at least one county for 2027.

    • Aetna (CVS) · 5 plans4,923
    • Medica Holding Company · 2 plans4,020

    The plans on sale in South Dakota for 2027

    Benefit design weighted by each plan’s members today, so a figure is what the market’s members are offered, not a count of plans. The rating is the 2027 overall Star Rating, weighted the same way.

    $0 premium
    76%

    of members are in a plan with no monthly premium

    In-network maximum
    $7,150

    median out-of-pocket maximum, member weighted

    Star Rating
    4.09

    2027 overall, member weighted

    Carrier Command · for Medicare Advantage plans

    The read on every carrier in South Dakota is in Carrier Command.

    A monthly position page for each of the 5 carriers here: risk and rebate against the market, Stars levers, the election-period forecast, county standing and the written read. Launching for Medicare Advantage plans.

    Request early access See Carrier Command

    Other states

    Every state has its own page; the largest carriers have one nationally.

    Medica Holding Company in every state · Blue Cross Blue Shield of Michigan Mutual Ins. Co. in every state · UnitedHealth in every state · All states and carriers

    How these numbers are made

    • Members are visible members: CMS suppresses any plan-county cell of ten or fewer, so small counties undercount. Market share excludes employer group plans.
    • Enrollment is Oct 2026; the twelve months run Nov 2025 to Oct 2026; the election step compares December 2025 with January 2026.
    • Plan fates are the ones assigned for contract year 2027; benefit design is the 2027 filing; the rating is the 2027 overall Star Rating of each carrier's contracts, weighted by members in South Dakota.
    • A carrier is a parent organization; its brands in South Dakota may carry other names. The rank 1st to 5th counts every parent with visible members in 2026.
    • Every figure comes from public CMS data as Livmor reads it, and the page is rebuilt when a new month posts. Livmor Carrier Command, public CMS data.